Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | ME0075838 | FL |
NPI | 1114012325 |
---|---|
Provider Name | Virginia Ann Ward |
First Address | St Petersburg, FL 33713-8603 |
Second Address | St Petersburg, FL 33713-8603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 26/05/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F89764 | (02) |